[Answered] Both the incidence of cancer and mortality continue to rise in the country, whereas it is declining rapidly in the US. What are the reasons behind such inequalities?

According to a report, deaths due to cancer have declined by 33% in the United States since 1991. This has translated into 3.8 million fewer deaths. In India, deaths due to cancer increased to an estimated 8.08 lakh in 2022 from 7.9 lakh in 2021 and 7.7 lakh in 2020. According to ICMR, India’s cancer burden to rise to 29.8 million in 2025.

Reasons behind such inequalities:

• Tobacco intake: Drinking, smoking and tobacco intake both in rural and urban areas is a major cause of cancer among men in India. Further, passive smoking also endangers others’ health.
• Accessibility: Unreachability of hospitals and poor diagnosis tools increases the cancer spreading to higher stages where it becomes difficult to treat.
• Poor public healthcare: Public healthcare is inadequate so people go to private hospitals for treatment . According to estimates, there are only 2,000 cancer specialists in India for 10 million patients.
• Fertilisers: Indiscriminate use of fertilizers in agriculture is one of the causes of cancer. Punjab to Rajasthan carry large number of such cancer patients.
• Cancer care facilities: We have one comprehensive cancer care centre for every 5 crore population. The WHO says there should be 1 radiotherapy machine per million populations in developing countries, so we need 1,400 machines, and we have only 700.
• There is an increase in rates of breast cancer, especially in urban centres because of later age of marriage, having the first child at a later age, not breastfeeding, and a high protein diet.
• Unlike cervical cancer, which can be prevented with HPV vaccination, there is no specific intervention for breast cancers other than screening because what causes it is unknown.
• The high treatment costhas seriously impacted survival rates. In the case of breast cancer, the five-year survival rate in India is estimated to be 65%. In high-income countries, it is nearly 90%.

India needs to prepare better. Better screening and treatment centres, and more comprehensive linkages between screening centres and hospitals are essential to reduce cancer mortality in the country.